A gay doctor has been denied an insurance policy for one reason: He took Truvada, a once-daily pill that protects against HIV infection nearly 100% of the time. And he’s not the only one.

Dr. Philip J. Cheng, a urology resident at Harvard’s Brigham and Women’s Hospital, first took Truvada three years ago after he nicked himself at work and was potentially exposed to HIV.

Per hospital protocol, he was prescribed a one-month supply of Truvada. After the month was up, he decided to keep taking the drug–not a bad call for a single gay man who has access to healthcare.

Sometime after, Cheng applied for disability insurance. Many young doctors purchase lifetime disability policies to protect them financially in the unfortunate case of an injury preventing them from working.

Cheng was only offered a five-year policy, though. Why? Because he took Truvada.

In a New York Times piece profiling this blatant discrimination, Cheng is described as a healthy young man who “has never had surgery or been hospitalized, and takes no other medication.”

“And I never engaged in sexually irresponsible behavior,” he said. “I’ve always been in longer-term monogamous relationships.”

His attempts to reason with the company were unsuccessful; he even offered to sign a document that would void his policy if he ever became HIV-positive.

Weighing his risks, he decided to stop taking Truvada. He then applied to another insurer and was given a lifetime policy.

So just to recap… the insurance companies wouldn’t protect Cheng until he significantly increased his odds of contracting HIV. Got it.

Via the Times:

…[I]nsurance brokers, gay-rights advocates and staff at medical clinics said in interviews they had heard of numerous such cases. H.I.V. specialists say the denials endanger men’s lives by encouraging them to drop PrEP if they need life, disability or long-term-care insurance.

The denials turn the insurance industry’s risk-management standard on its head: men who do not protect themselves can get policies, while men who do cannot.

“It doesn’t make any sense,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “It ought to be the other way around.”

Dr. Robert M. Grant, the AIDS researcher at the University of California, San Francisco, said the practice, which unfairly targets gay men, is “like refusing to insure someone because they use seatbelts.”

The explanation of the insurance companies follows the flawed logic that if someone is taking Truvada as PrEP, they are likely to be regularly engaging in high-risk sex.

theszak

frankcar1965

Very flawed and dangerous thinking, you are only negative at the time you take the test. You are encouraging bad practices and relying on someone’s word that they only have sex with YOU. People lie all the time and cheat all the time.

February 13, 2018 at 3:02pm

theszak

> Very flawed and dangerous thinking

Compare not getting tested TOGETHER.

> , you are only negative at the time you take the test.

An infection can turn up.

> You are encouraging bad practices

Finding out TOGETHER about an infection gives sex partners information for INFORMED decisions.

> and relying on someone’s word that they only have sex with YOU. People lie all the time and cheat all the time.

CastleSF

It’s disability insurance that is discussed here so the insurance companies have every right to set their own price, knowing well that people who take PrEP tend to have riskier and more frequent sex with multiple partners, which in turn increases the chances for them to get other nasty infections like HepC. The higher disability insurance premium hopefully will curtail gay’s irresponsible and reckless behaviors.

Kieru

I see this argument all the time but it just doesn’t work.

A person on PrEP may have frequent sex with multiple partners, but they are also committing to taking a pill to DECREASES risks associated with that behavior. That prescription also REQUIRES you to visit your physician every 3 months and get regular tests for HIV. If your physician knows you’re engaging in casual sex he or she will undoubtably recommend regular STI panels.

You know what we call someone taking steps to ensure they don’t contract HIV? Whose steps result in regular office visits, sexual wellness screenings, etc? We call that a responsible person.

February 13, 2018 at 4:02pm

Juanjo

You have made a number of amusing assertions here which are not supported by verifiable facts. Not to mention that people who are in certain professions like being a doctor or nurse have a greater likelihood of receiving an exposure to HIV through needle sticks or other non-sexual exposures in the course of their work.

Other large, industrialized countries with universal, single payer programs (that in some cases include private insurers) and highly regarded health care systems cost far less per person: Germany ($5,551); Canada ($4,753); France ($4,600); Japan ($4,519); UK ($4,192); South Korea ($2,729). We are getting robbed in the US, on top of the discriminatory actions of these disability insurers. Nevertheless, many millions (22 million+) now have access to health care insurance, if not always affordable health care (see above) yet, because of the ACA.

KaiserVonScheiss

Also, he wasn’t applying for health insurance. He applied for disability insurance.

February 13, 2018 at 6:02pm

Kangol

@KaiserVS, you’re right, France isn’t single payer.

I did say, though, “We are getting robbed in the US, on top of the discriminatory actions of these disability insurers,” in recognition of the fact that our health insurance system is too costly AND these disability insurers are screwing Dr. Cheng.

February 13, 2018 at 9:02pm

Juanjo

Kaiser Von Shithead is correct that France does not have single payer insurance but the government sets the rates that can be charged and the levels of co-pays and reimbursements for consumers. The average person using the plan used by 82% of the population pays around 10 euros a month for insurance which covers all medical care and medication including dental and vision. That person pays 6.60 euros for an office visit for his treater. He pays 28 euros for a root canal. He pays 14.50 euros to see a cardiologist. So at the present exchange rate that French person is paying around $12.40 cents a month for his health premium. Of course, he can go with a premium plan which is 124.00USD a month if he wishes. That gets him a deluxe hospital room, private tutoring for kids if they are unable to attend school because of illness or injury, and in-home maid and other services during recovery.

How much is your monthly premium and co-pay?

February 13, 2018 at 11:02pm

Sam6969

It is a chance those insurance companies cannot ask (I hope so) if the person is gay or straight (or that, at least, they cannot use this piece of information they can certainly get in other ways). Considering their rationale, if insurance companies had the right to do so, gay men may well pay more on statistical justifications.

Bulovaboy

I Want to know why they can make Truvada affordable but not the the rest of the meds that go with it? It’s just bullshit, People with long term conditions regardles of what they are should have an affordable prescription price. NY State would not have to pay for those who can’t afford the costly prices that they charge. And since NY State pays for those drugs for those that can’t afford it they are not allowed to have savings over 25K. So even though they can’t afford the drugs they are also not allowed to secure their living arrangements for there senior years. It is not fair that they can make a prevention drug affordable, but not the other drugs that are a “NECESSITY” TO SURVIVE FOR THOSE THAT ARE GRANDFATHERED AND FOR FUTURE CASES. THIS SYSTEM IS SO F___ED UP.